Individual
ELISSA J HUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 NW 31ST ST, 3RD FLOOR, LAWTON, OK 73505-6100
(580) 510-7042
(580) 510-7044
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22510
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020053163
RAILROAD MEDICARE
—
05
—
100097930A
—
OK
01
—
347459110
DOL
KS
01
—
7648345
AETNA
OK
Enumeration date
09/22/2005
Last updated
01/13/2009
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